scholarly journals Supporting IOL’S in a Deficient Capsular Environment: The Tale of No “Tails”

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Domenico Boccuzzi ◽  
Date Purva ◽  
Vincenzo Orfeo ◽  
Pasquale Napolitano ◽  
Alessandro Mularoni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Procedures ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Implantation Techniques ◽  
Retrospective Comparative Study ◽  
Capsular Support ◽  
Iris Claw

Purpose. To evaluate the efficacy and safety of the following three distinct surgical procedures for secondary IOL implantation without capsular support: Iris-claw lens, flanged transscleral fixated IOLs (Yamane technique), and sutureless transscleral hook IOL fixation (Carlevale IOL). Materials and Methods. In this retrospective comparative study, three different sutureless IOL implantation techniques were compared in patients without any capsular support. Visual acuity and outcomes were analyzed in 24 eyes of 23 patients (14 male and 9 female). Study included 13 iris-claw lenses (Artisan Ophtec), 6 flanged transscleral fixated IOLs (Yamane technique using a MA60MA Alcon Inc IOL), and 5 transscleral Carlevale IOLS (Carlevale IOL, Soleko, Italy). Results. logMAR mean best-corrected visual acuity (BCVA) improved from 0.49 ± 0.19 to 0.19 ± 0.10 at three months after surgery p < 0.05 . Postoperative BCVA was similar in all three groups, and no intergroup difference was noted. Three eyes (12.5%) had a raised IOP >25 mmHg, 2 eyes (8%) presented a subluxated/dislocated IOL, 4 eyes (16%) had corneal edema longer than 7 days, 3 eyes (12.5%) had irregular pupil profile, 2 eyes (8%) had vitreous hemorrhage, 7 eyes had (29%) corneal astigmatism over 3 diopters, and one patient (4%) developed cystoid macular edema (CME). Conclusions. All three surgical procedures can be considered adequate to correct aphakia in patients without capsular support with significant improvement in visual acuity and low complication.

scholarly journals Nucleus Drop or Intraocular Lens Drop Underwent Pars Plana Vitrectomy due to Complication of Cataract Surgery

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Noviana Kurniasari Vivin ◽  
Ari Djatikusumo ◽  
Elvioza Elvioza ◽  
Gitalisa Andayani ◽  
Anggun Rama Yudantha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Pars Plana Vitrectomy ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Choice Of Procedure ◽  
Department Of Ophthalmology ◽  
Pars Plana

Abstract Background: The incidence of nucleus drop or intraocular lens (IOL) drop as the complication of phacoemulsification increases due to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary IOL implantation is the choice of procedure for management. This study aims to determine the frequency, outcomes, and complication of PPV in the case of nucleus drop or IOL drop in the Department of Ophthalmology, Fakultas Kedokteran Universitas Indonesia – Rumah Sakit Cipto Mangunkusumo (FKUI-RSCM) Methods: This study is a retrospective descriptive study conducted in the Vitreoretinal Division of the Department of Ophthalmology, FKUI - RSCM. Research data was taken from the medical records of all nucleus drop or IOL drop patients underwent PPV in January 2017-December 2017. Results: There were 19 cases studied. The incidence of nucleus drop occurred in phacoemulsification surgery techniques (94.7%) and ECCE techniques (5.3%). Vitrectomy surgery was performed ≤2 weeks in 31.6% and >2 weeks in 68.4% after the patient first arrived at the vitreoretinal clinic. Most pre-PPV visual acuity was 1/60-6/60 (47.1%). In the final follow-up, visual acuity improved from 6/45 to 6/6 occurred in 42.2% of cases. Complication after PPV and secondary IOL implantation include elevated IOP (10.5%), IOL decentration (5.3%), corneal decompensation (5.3%), macular edema (5.3%), and retinal detachment (5.3%). Conclusion: Nucleus drop or IOL drop generally occurs in phacoemulsification cataract surgery techniques. Improved visual acuity was achieved after PPV and secondary IOL implantation at the end of the follow-up period. Most common post-PPV complication is elevated IOP.  

scholarly journals Prognostic Factors for Low Visual Acuity after Cataract Surgery with Vitreous Loss

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Michael Mimouni ◽  
Michal Schaap-Fogler ◽  
Philip Polkinghorne ◽  
Gilad Rabina ◽  
Rita Ehrlich
Keyword(s):  
Visual Acuity ◽  
Prognostic Factors ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Visual Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Vitreous Loss

Purpose. The purpose of this study is to find prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery. Methods. A retrospective, noncomparative, interventional, case study of patients experiencing vitreous loss during cataract surgery. Data collected included demographics, best corrected visual acuity (BCVA), axial length (AL), presence of ocular comorbidity affecting central vision, timing of intraocular lens (IOL) implantation, position of the implanted lens, and the presence of corneal sutures. Low visual outcome was defined as BCVA < 20/40. Results. Overall, 179 patients (60.3% males) with a mean age of 73 ± 12 years and axial length of 23.5 ± 1.3 mm with a mean follow-up of 12 ± 13 months were included. In multivariable logistic regression analysis, low visual outcome was independently associated with persisting postoperative complications (OR 6.25, 95% CI 1.378–30.9), preexisting ocular comorbidities (OR 4.45, 95% CI 1.1–18.00), and secondary intraocular lens (IOL) implant (OR 10.36, 95% CI 1.8–60.00). Conversely, pars plana vitrectomy (PPV) for dislocated fragments of lens material, age > 70 years, gender, axial length, degree of surgeon, corneal suturing, and anterior chamber lens implantation were not found to have significant associations with low visual outcomes ( P > 0.05 ). Conclusions. Low visual outcome after vitreous loss during cataract surgery was associated with ocular comorbidities, secondary IOL implantation, development of cystoid macular edema, and additional surgical complications.

scholarly journals Primary and Secondary Intraocular Lens Implantation in Congenital Cataract Surgery: A Retrospective Comparative Study of the Visual Outcomes

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Congenital Cataract ◽  
Iol Implantation ◽  
Visual Outcomes ◽  
Secondary Iol Implantation ◽  
Myopic Shift ◽  
Congenital Cataract Surgery

Objectives: To compare visual outcomes, principally myopic shift, visual acuity, intraocular pressure and strabismus between primary and secondary intraocular lens (IOL) implantation following congenital cataract surgery. Methods: A retrospective study of the long-term ocular outcomes in primary versus secondary IOL implantation (IOL-I) following congenital cataract surgery was conducted. We analyzed the files of all children with congenital cataract who underwent unilateral or bilateral lensectomy, posterior capsulotomy and anterior vitrectomy followed by primary or secondary IOL-I between 2000 to 2012, at King Abdulaziz University Hospital, Jeddah. Preoperative and postoperative assessment of each operated eye in terms of axial length, refractive errors, strabismus as well as (post IOL-I) intraocular pressure (IOP) and best corrected visual acuity (BC-VA) were collected and analyzed. Results: Data of 26 eyes of 14 patients (9 males, 6 females) was analyzed: 16 (61.5%) eyes underwent lensectomty and anterior vasectomy with primary IOL-I and 10 (38.5%) eyes underwent lumpectomy and anterior vasectomy with secondary IOL-I. Mean age at cataract surgery was 67.53 (± 48.70) months in the group of primary IOL-I versus 5.90 (± 3.72) months in the group of secondary IOL-I; and patients were followed up for 49.33 (± 26.23) versus 86.50 (± 23.36) months, respectively (p=.051). In the secondary IOL-I group, the mean of time from primary lensectomy to IOL-I was 50.44 (± 18.41) months. Last BC-VA showed better outcomes in primary IOL-I group as 10 eyes (83.3%) with good VA versus only 2 eyes (20%) in the secondary IOL-I, (p=0.009). Myopic shift was greater in secondary IOL group 10.86 (± 11.62) versus 0.19 (± 2.38) diopters (D) in primary IOL (p=0.046*); while no significant difference was observed in IOP (p=0.697). No case of isotropic was detected in primary versus 6 cases in the secondary IOL group. Conclusion: Visual outcomes, including visual acuity, strabismus and myopic shift were better in the group of children who underwent primary IOL implantation at age of >2 years, when compared to those with secondary IOL implantation at the age of <2 years, following congenital cataract surgery. However, poor visual acuity in the secondary IOL group was mainly explained by the relatively higher prevalence of eye complications in this group.

scholarly journals Ocular injuries caused by airsoft guns: Ten-year experience

2012 ◽  
Vol 59 (3) ◽  
pp. 73-76 ◽  
Author(s):  
Milos Jovanovic ◽  
Anica Bobic-Radovanovic ◽  
Dragan Vukovic ◽  
Miroslav Knezevic ◽  
Dusica Risovic
Keyword(s):  
Visual Acuity ◽  
Age Groups ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Posterior Segment ◽  
Initial Examination ◽  
Globe Rupture ◽  
Duration Of Hospitalization ◽  
Ocular Injuries

INTRODUCTION: The study describes ocular injuries caused by airsoft guns pellets, type of these injuries and their incidence in different age groups. METHODS: This is a retrospective review of medical charts of patients who were hospitalized due to airsoft guns ocular injuries in ten-year period (from 2000 to 2009). Patient?s age, gender, duration of hospitalization, type of treatment and initial and final visual acuity were analyzed. RESULTS: Overall 92 patients with ocular injuries caused by airsoft gun pellets were hospitalized in tenyear period. In all patients only one eye was injured and there were 72 (78.3%) male patients. Injuries involved ocular adnexa, anterior and posterior segment of the eye. On initial examination 41 (44.6%) patients were presented with subconjunctival hemorrhages, 42 (45.6%) with corneal abrasion, 42 (45.6%) patients had corneal edema, 6 (6.5%) had traumatic mydriasis, 90 (97.8%) patients exhibited hyphema, 10 (10.9%) iridodialysis, in 27 (29.3%) patients high intraocular pressure (IOP) was measured, one patient had subluxation of intraocular lens (IOL) and one patient had traumatic cataract. Posterior segment findings included vitreous hemorrhage in 3 (3.3%) patients, retinal hemorrhage in 15 (16.3%) patients, retinal edema in 35 (38.0%) patients and one patient had globe rupture. Average duration of hospitalization was 5.7 days (range from 1 to 18 days). Three patients (3.3%) required eye surgery, eight patients (8.7%) had anterior chamber washout while rest of the patients were conservatively managed. Visual acuity at hospital release was significantly improved comparing to initial visual acuity, ranging from counting fingers at 1 meter to 20/60 in 7 (8.6%) patients, from 20/50 to 20/30 in 13 (16.0%) patients and from 20/25 to 20/20 in 61 (75.3%) patients. In 11 patients testing the visual acuity was not possible because of their young age. CONCLUSION: Injuries attributed to airsoft guns were confined mostly to anterior segment. There was also high percentage of severe posterior segment trauma requiring hospital admission. The most important factors in preventing such injuries are restricting access to airsoft guns, especially to minors, as well as mandatory use of protective equipment such as protective eyeglasses.

scholarly journals Visual outcome and early complications of sutureless and glueless scleral fixated intraocular lens

2016 ◽  
Vol 8 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Lalit Agarwal ◽  
Nisha Agarwal ◽  
Rajya Laxmi Gurung ◽  
Rahul Chaubey ◽  
Bhaskar Kumar Jha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Case Series ◽  
Corneal Edema ◽  
Visual Outcome ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Study Results ◽  
Capsular Support ◽  
Scleral Fixated Intraocular Lens

Introduction: In the absence of capsular support, anterior chamber intraocular lens (IOL), iris fixated IOL and sutured scleral fixated intraocular lens (SFIOL) implantation have been performed for many years. Recently sutureless glued SFIOL have been used as a primary or secondary procedure to correct aphakia. In this study we have used sutureless and glueless technique of SFIOL implantation. Methodology: An interventional case series was conducted. Aphakic patients without capsular support, sub-luxated lens (>180°), dislocated lens and dislocated IOL were the inclusion criteria. The patients with hazy cornea, non-dilating pupil, macular scar and glaucoma were not enrolled in the study. Results: Of 62 eyes who completed 1 month follow- up, 48 were men and 14 women. There was a significant improvement in uncorrected distance visual acuity after surgery (p<0.001). One month postoperative best corrected distance visual acuity was 6/18 or better in 45 eyes (72.6%). The common early postoperative complications were hypotony, corneal edema. No serious complications such as endophthalmitis and retinal detachment were seen. Conclusion: Our technique of sutureless and glueless SFIOL implantation showed good visual outcome in the absence of serious complications. SFIOL will be the only choice in eyes that have anatomic contraindications like non constricting pupil, large sectoral iridectomy and peripheral anterior synechia in which other types of lens are not suitable.Nepal J Ophthalmol 2016; 8(15): 41-46 

scholarly journals Secondary Sulcus-Fixed Foldable IOL Implantation with 25-G Infusion in Patients with Previous PPV after Open-Globe Injury

2017 ◽  
Vol 27 (6) ◽  
pp. 786-790
Author(s):  
Tiangeng He ◽  
Caiyun You ◽  
Song Chen ◽  
Xiangda Meng ◽  
Yuanyuan Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Open Globe Injury ◽  
Corneal Incision ◽  
Iol Implantation ◽  
Clear Corneal Incision ◽  
Secondary Iol Implantation ◽  
Open Globe ◽  
Uncorrected Visual Acuity ◽  
Pars Plana ◽  
The Mean

Purpose To evaluate the safety and efficacy of secondary sulcus-fixed foldable intraocular lens (IOL) implantation through a clear corneal incision with 25-G infusion in patients with previous pars plana vitrectomy (PPV) after open-globe injury, and to analyze postoperative outcomes and prognostic factors of treatment. Methods Clinical data of 89 eyes of 89 patients with open-globe injury who underwent secondary sulcus-fixed foldable IOL implantation through a clear corneal incision with 25-G infusion after vitrectomy in our hospital between January 2008 and June 2015 were retrospectively analyzed. The examinations before IOL implantation mainly included visual acuity, slit-lamp examination, direct and indirect ophthalmoscope, visual electrophysiology, corneal endothelium, B scan, ultrasound biomicroscope, and intraocular pressure. Five eyes underwent suturing of peripheral iris and 7 eyes underwent suturing of iris laceration simultaneously. The mean follow-up was 18 months with a range from 6 months to 8 years. Results The mean interval between secondary sulcus-fixed foldable IOL implantation and vitrectomy was 2.8 months with a range from 2 to 6 months. The uncorrected visual acuity improved in all patients with a well-centered IOL ranging from 0.1 to 0.8 with the best-corrected visual acuity from 0.1 to 1.0 after secondary IOL implantation. The postoperative complications mainly included mild anterior chamber exudates in 10 eyes (11%), temporary IOP elevation in 12 eyes (13%), and recurrent retinal detachment in 5 eyes (6%), which were subsequently managed by surgery. Conclusions The interval of 2.8 months between vitrectomy and secondary IOL implantation is an appropriate and safe option to correct aphakia in patients receiving vitrectomy for open-globe injury.

scholarly journals Secondary IOL implantation without capsular support. A laser flare cell-meter study

2007 ◽  
Vol 85 ◽  
pp. 0-0
Author(s):  
GO BRAVETTI ◽  
P LEONETTI ◽  
M MANDRIOLI ◽  
E STROBBE ◽  
M CELLINI ◽  
...  
Keyword(s):  
Iol Implantation ◽  
Secondary Iol Implantation ◽  
Laser Flare ◽  
Capsular Support

scholarly journals The SWISS IOL Technique (Small-Width Incision Scleral Suture): A Mini-Invasive Technique

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mateusz Kecik ◽  
Bojan Pajic ◽  
Olivier Le Quoy ◽  
Gabriele Thumann ◽  
Horace Massa
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Corneal Edema ◽  
Invasive Technique ◽  
Support Materials ◽  
Small Width ◽  
Single Technique ◽  
Iol Dislocation

Purpose. To evaluate the outcomes and safety of a minimally invasive technique for sutured IOL scleral fixation in case of compromised capsular and iris support. Materials and Methods. In this retrospective study, we explain our mini-invasive technique and assess the outcomes in terms of visual acuity, pre- or postoperative complications, and IOL position (Sensar AR40e, AMO) in a case series of three patients. Results. The expected best corrected visual acuity could be achieved after one month. Surgeries were uneventful with a stable eye. No postoperative complications occurred except for one patient who had a conjunctival disinsertion. Neither postoperative hypotony nor raised IOP was found. Additionally, no patient experienced corneal edema at one week control, IOL dislocation, vitreous hemorrhage, or new pupil’s irregularity. Conclusions. In conclusion, each scleral technique has its own advantages and its inherent postoperative complications. To date, there is no evidence of superiority of any single technique. By improving our scleral sutured lens techniques, we could improve peroperative ocular stability, potentially decrease postoperative complication rate, and offer a rapid recovery with a stable visual acuity within a month.

scholarly journals Pars Plana Lensectomy and Iris-Claw Artisan Intraocular Lens Implantation in Patients with Marfan Syndrome

2021 ◽  
Author(s):  
Saeed Karimi ◽  
Zahra Karjou ◽  
Mohadeseh Yaghoobi ◽  
Homayoun Nikkhah ◽  
Sare Safi
Keyword(s):  
Visual Acuity ◽  
Marfan Syndrome ◽  
Crystalline Lens ◽  
Safe Procedure ◽  
Iol Implantation ◽  
Lens Subluxation ◽  
Pars Plana Lensectomy ◽  
Pars Plana ◽  
The Mean ◽  
Iris Claw

Abstract Purpose: To evaluate the visual and anatomical outcomes of pars plana lensectomy and iris-claw artisan intra-ocular lens (IOL) implantation in the patients with subluxated crystalline lens secondary to Marfan syndrome.Methods: In this retrospective case series, we evaluate the records of all patients with Marfan syndrome and moderate to severe crystalline lens subluxation who underwent pars plana lensectomy/anterior vitrectomy and implantation of iris-claw artisan IOL at referral hospital from September 2015 to October 2019.Results: Twenty-one eyes of fifteen patients (10 males and 5 females) with the mean age of 24.47 ± 19.14 years were included. Mean best-corrected visual acuity was improved from 1.17 ± 0.55 logMAR to 0.64 ± 0.71 logMAR at the final follow-up visit (P <0.001). The mean intraocular pressure did not change significantly (P = 0.971). The final refraction showed a mean sphere of 0.54 ± 2.46 D and a mean cylinder -0.81 ± 1.03 at the mean axis of 57.92 ± 58.33 degrees. One eye developed rhegmatogenous retinal detachment two months after surgery.Conclusion: Pars plana lensectomy and iris-claw artisan IOL implantation seem to be a useful, impressive and safe procedure with a low rate of complications in Marfan patients with moderate to severe crystalline lens subluxation. Visual acuity was significantly improved with the acceptable anatomical and refractive outcomes.

scholarly journals Anterior iris-claw lens implantation with single paracentesis

2011 ◽  
Vol 1 (2) ◽  
pp. 26
Author(s):  
Ahmet Özer ◽  
Leyla Niyaz
Keyword(s):  
Prospective Study ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Corneal Edema ◽  
Surgical Time ◽  
Corneal Incision ◽  
Iol Implantation ◽  
Lens Implantation ◽  
Iris Claw Lens ◽  
Iris Claw

In this study, the technique and results of iris-claw intraocular lens (IOL) implantation with corneal incision and single paracentesis were presented. Eighteen eyes of 18 patients who underwent iris-claw implantation surgery with a single paracentesis were included in this prospective study. Iris-claw lens was grasped by its forceps and placed into the anterior chamber through superior corneal opening. While IOL was held by forceps, a blunt enclavation spatula was introduced through inferior paracentesis. Then the spatula was directed toward underneath of iris through pupil and toward sides where iris was entrapped into the claw by gentle push of iris through the slotted center of the lens haptics. Mean age of patients was 54.28±25.21 years (7-76 years). Mean anterior chamber depth was 4.07±0.32 mm and mean keratometric power was 43.01±2.73 D. Preoperative BCVA was 20/63 or better in 8 (44.4%) patients. At the first postoperative month BCVA was 20/63 or better in 14 (77.8%) patients. Preoperative mean spherical refraction was +11.05±2.62 D, preoperative astigmatism was 2.15±0.85. Postoperative mean spherical refraction was - 0.58±0.25 D and mean astigmatism was - 1.92±0.67 D. The most frequent postoperative complication was mild corneal edema seen in three patients that resolved completely during the first week with medical treatment. Irisclaw IOL implantation can be performed easily with corneal incision and single paracentesis. Single paracentesis does not increase surgical time or cause inconvenience during the procedure.

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